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Ddb%ltd 97 15:34 D I LLRRD-ENV*** i 9166565277 N0.S34 1?02 <br /> WAS <br /> BES <br /> AL TOS <br /> i <br /> tr `'fit if 9ke:Is"ashesfas este a4ti1ph9ie Secons'T,` r"iii and Ill. 7 <br /> tt w rs"N T asls otos waste,'c 19t9!�Only'$ i0rts I 3i and [Et. N� � i <br /> °mP. u. t I <br /> Gerlsratrar.NBma Compaiay b nera _ <br /> ® Arno Station ;� 54y <br /> tl Prodartr Ge tint locaklar} <br /> c. Address; <br /> see-on Ave. Ste. 1202 d. Address Z #7 Want. Fremont I <br /> 11 CA CA gi0C7$ Stockton, CA <br /> ... <br /> {4(36 ,w7;;o96 ono : <br /> e. Phone Na.: t. Prune Na:. <br /> If owner of the"yeneratin8:•facitity'differs from the generator, provide: <br /> ,. .,• " "#?YOdiTCL'aseine; yes• F(e) "s' <br /> 011rar's.13ar»e: ---_--- - h. Owner's Friona No.; <br /> TYPE !r: <br /> i. BF WASTE GOC?E A 4 0 1 C 3 1' g a S 0 8 2 Containers DM•METAL DAUM' <br /> pP -PLASTIC DRUM <br /> CoA Hazartio.tts 5tx! (TPP 9 k. Qu01111t Unite No. TYPE BA -8 MIL. PLASTIC 8A3 <br /> }. Description of 1Naste; or WRAP <br /> i L 1 FF T - <br /> J TRUCK <br /> if <br /> GENERATOR'S CERTIFICATIQNI I hereby certify that the above named matarlai Is not a hazardous waste as defined by 40 CP13 Part 281 UNITS <br /> or any applicabre atata law,"has been properly described,classirled and packaged,and is in proper omdltlon for lranaportalion according to. P -POUNDS <br /> applicable reputations;AND,if the waste Is a treatment residua of a prtavlousty restricted hazansous waste subjoct to the Land Disposal }I Y �YARDS <br /> Re b-ittionS,1 certify and wiltriant that the'waaie ties 10600 treated-in accomanc with the requirements.M 40 GFR Part 8158 and is ns.longer" Ma-CUBIC MVERS - <br /> P haZardoue waste as denned by 40 CFR wan 261.E t tltf Request f� ARCO Pi,odde t Y3 •CUBIC YARDS <br /> 0 -OTHER <br /> aenormor Authorized Agent IOK4: SidnaEura &upmanl Date <br /> T.113i5PORTER 1 TRANSPO FAH ER FI <br /> a. Name: f let tf.9'�`ucL ing, In(,. h. Name: <br /> b. Address: ; ." p8 21.8 i. Address: <br /> Llyrot],r A 94514 <br /> c_ Driver NarnelTit �.- <br /> le; Driver Name: <br /> e/7itl _ PAiNrirvre"""• - ' -. . <br /> f 510) 634_4683(�� <br /> d- Phone No.: c e. Truck No. k. Phone No,:': I• Truck No.: <br /> t• Vehicle License Na./State:": 1� �� e7 _ {�` m.Vehicie.LicanSB Na•lStdtra: " <br /> Acknow) gam ec)lpt of Materials. Acknowledgement of Receipt of M§064 ,ls- <br /> g p ver 5ignalura SM! _I Data Driver Signature t. Shipment Cate ' <br /> a. Site Name: $FI Vai§C J Pd. Landfill . c. 'M+one No,:�'�"5IQ i �4�-���1. " <br /> ' 4001 No,-th Masao Road 4001 North Vtt.*10 Ropid <br /> ` b. Physical Address: d. Mali irig Address: <br /> a <br />' Livirrm*l!' CA U115 0 i.Aveewerb: !'A 94550 <br /> e. Disorepancy Indication Space: -- --- _ --— <br /> I hereby certify that the above n6mi ed material hgto been aeo®pted and to the best of my knowledge the foregoing Is true and accurate. <br /> Name of Aulhortted',A96nl 51gnature neceipt Pate <br /> E - ,�,_ " <br /> ti a. Operator'8` Name: _ b. Operator's" Ahnne Na.: <br /> c. Operators' Address; - - - <br /> d. Special Handling Instructions and additlonal information,' <br /> OPERATOR'S CERTIFICATION: I hereby dool8fe titbit the contents Of(Pis consignment are fully and accuratelydescrlbed above t3y prpper shipping name and are classified, <br /> packed,mafked,and labeled,end WO in ell rggpecta in proper condition for transport by highway sccordl ng to applicable International and government tegulatiOAS. <br />